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KMID : 0378019900330020083
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New Medical Journal
1990 Volume.33 No. 2 p.83 ~ p.87
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The Significance of C-reactive Protein Level in the Premature Newborn with Premature Rupture of Membrances
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Abstract
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Early recognition and management of infection in newborns born after premature rupture of membranes are significant due to increasing risk for serious perinatal infection. C-reactive protein level measured shortly after birth could be more sensitive indicator than any other indices of fetal-neonatal infection because that it can be detected in peripheral blood 6-12 hours after the onset of infection and also has no placental transfer.
The purpose of this study was the evaluation of the significance of indicators, especially C-reactive protein in predicting the early onset neonatal infection after premature rupture of membranes.
Total 30 premature newborns of 28-37 weeks of gestational age born after premature rupture of membranes over 12 hours were observed. Nine neonates had shown culture proven infections during the first week of life(Infected group), and the other, twenty-one neonates had no evidences of infection (Control group).
The evidences of amnionits, laboratory findings including gastric juice culture, total neu trophil count, immature/total neutrophil ratio was investigated. C-reactive protein was Treasured quantitively by turbidometric immunoassay within 4 hours and 48-72 hours after birth.
The results were as follows.
1. There were no significant differences in gestational age and birth weight between _nfected and control groups.
2. The evidences of amnionitis were observed in 56% of infected group and 5% of control group. Only 2 cases of infected group (22%) were positive for pathogenic bacteria in gastric juice culture.
3. Total neutrophil count and immature /total neutrophil ratio in infected and control group 10,600±9,300, 6,500+1,900 / mm3 and 0.10+0.09, 0.01±0.01 were not significantly different.
4. C-reactive protein levels within 4 hours and 48-72 hours after
birth were significantly higher in infected group (4.4 + 0.9 and 9.7 f 3.6mg / dl) than in control group (2.3 + 1.4 and 2.4+1.6mg/dl)(P<0.01).
These data suggest that measurement for C-reactive protein levels during the first 3 days of life could be used as an indicator of the early onset neonatal infections in premature newborns with premature rupture of embranes.
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